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Manually Entering a Claim

Version 20.3

Overview

Follow the steps below to create a claim in the Patient Chart. This workflow is different from entering superbill charges, which then have to be converted to a claim. 

  1. Click the Patient Chart button on the Clinical, Billing, or Practice Management tab.
  2. If needed, use the Search boxto search for and select the patient.
  3. Click Charges in the Account section of the Window Navigation Panel.
  4. Click the New Claim button.The Add/ Edit Charges window is displayed. 
  5. Enter the following information (items in red are required fields):
  • Rendering Provider: Select the Provider that saw the patient. If the Rendering Provider does not have billing credentials, a name must be selected from the Supervised by drop-down menu.

  • Insurance or Self-pay: The patient's primary insurance is displayed here. There is the option to select an alternate payer or self-pay for this claim.

  • Date: The system default is the current date. To backdate the claim, click the drop-down menu to change to the desired date.

  • ICD-10: Click the Add button  and enter the numeric code or description to search under the ICD-10 Desc field. Then, click the Save button  to add the diagnosis code to the claim. Up to twelve diagnosis codes can be placed on a claim.
  • CPT: Enter the numeric CPT code or click the Ellipsis button to search for the code.
  • Diagnosis codes must be assigned to each CPT code line. Use the drop-down menu to select the diagnosis code or add modifiers.

Note:

As you are manually creating claims or converting electronic superbills, you may find that you need to record other claim information that is not found in the Basic Information tab of the Add/Edit Charges window. This is where you will use the Other Items (1-27) tab. The Other Items (1-27) tab in the Add/Edit Charges window is described below. 

The Other Items (1-27) tab can be used to add or edit the following claim information:

  • Type of Insurance coverage (this is defaulted according to the Insurance carrier for the claim and should not need to be edited)
  • Claim relation to employment, auto, or other accident
  • Dates of illness or injury as they pertain to the claim
  • Referring or Ordering Physician(s) and their NPI numbers
  • Referral or Prior Authorization numbers
  • Any other locally reported items as dictated by your state's insurance companies

  1. Once all charges have been entered click the Save or Save + Queue button in the bottom right hand corner of the Add/Edit Charges window.
Version 20.2

Overview

Follow the steps below to create a claim in the Patient Chart. This workflow is different from entering superbill charges, which then have to be converted to a claim.

  1. Click the Patient Chart button on the Clinical, Billing, or Practice Management tab.
  2. If needed, use the Search boxto search for and select the patient.
  3. Click Charges in the Account section of the Window Navigation Panel.
  4. Click the New Claim button.The Add/ Edit Charges window is displayed. 
  5. Enter the following information (items in red are required fields):
  • Rendering Provider: Select the Provider that saw the patient. If the Rendering Provider does not have billing credentials, a name must be selected from the Supervised by drop-down menu.

  • Insurance or Self-pay: The patient's primary insurance is displayed here. There is the option to select an alternate payer or self-pay for this claim.

  • Date: The system default is the current date. To backdate the claim, click the drop-down menu to change to the desired date.

  • ICD-10: Click the Add button  and enter the numeric code or description to search under the ICD-10 Desc field. Then, click the Save button  to add the diagnosis code to the claim. Up to twelve diagnosis codes can be placed on a claim.
  • CPT: Enter the numeric CPT code or click the Ellipsis button to search for the code.
  • Diagnosis codes must be assigned to each CPT code line. Use the drop-down menu to select the diagnosis code or add modifiers.

Note:

As you are manually creating claims or converting electronic superbills, you may find that you need to record other claim information that is not found in the Basic Information tab of the Add/Edit Charges window. This is where you will use the Other Items (1-27) tab. The Other Items (1-27) tab in the Add/Edit Charges window is described below. 

The Other Items (1-27) tab can be used to add or edit the following claim information:

  • Type of Insurance coverage (this is defaulted according to the Insurance carrier for the claim and should not need to be edited)
  • Claim relation to employment, auto, or other accident
  • Dates of illness or injury as they pertain to the claim
  • Referring or Ordering Physician(s) and their NPI numbers
  • Referral or Prior Authorization numbers
  • Any other locally reported items as dictated by your state's insurance companies

  1. Once all charges have been entered click the Save or Save + Queue button in the bottom right hand corner of the Add/Edit Charges screen.